The Journal of surgical research
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This study was conducted to assess the efficacy of preoperative chemoradiation followed by transanal excision among patients with locally advanced lower rectal cancer. ⋯ Transanal excision after preoperative chemoradiation in highly-selected patients with locally advanced lower rectal cancer could probably be an acceptable alternative to conventional radical surgery. However, this approach should be prospectively validated, and strict patient selection criteria should be used.
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The need for leadership training has become recognized as being highly important to improving medical care, and should be included in surgical resident education curriculums. ⋯ Areas of resident leadership strengths and weaknesses were identified. The Multifactor Leadership Questionnaire was demonstrated to be a valuable tool for identifying specific areas where leadership training would be most beneficial in the educational curriculum. The future use of this instrument could prove valuable to surgical education training programs.
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Comparative Study
Extracorporeal membrane oxygenation for cardiopulmonary failure in pediatric patients: is a second course justified?
Extracorporeal membrane oxygenation (ECMO) is accepted therapy for cardiorespiratory failure. Even after a successful ECMO course, patient deterioration may occur and a second course of ECMO may be contemplated. Although data regarding second ECMO courses exist in neonates, there are no reports describing second ECMO courses in pediatric patients. We hypothesized that data from a national ECMO registry would be useful in identifying which pediatric patients would be optimal candidates for a second course of ECMO. ⋯ ECMO therapy achieves 49% survival in children 1-18 years of age. When a second ECMO course becomes necessary, survival rates comparable to the first ECMO course are possible. Patients developing renal complications during their first ECMO course have worse outcome with a second ECMO course. Patients are at greater risk for complications during a second ECMO course if they experience a high number of first-run complications, are >3 years old, or undergo a prolonged second ECMO course. These data are useful when deciding whether to offer a second ECMO course to an eligible pediatric patient.
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To evaluate the scientific impact of women in the surgical literature. ⋯ Although women comprise a small proportion of principal investigators on abstracts presented at these conferences, the quality of their presented work is equal to or better than those of their male counterparts.
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The objective of this study was to determine the utility of a lateral cervical spine plain film in the evaluation of blunt trauma patients. ⋯ LCS has no value as a screening tool in the blunt trauma patient since most are either inaccurate or incomplete. It should be eliminated from the Advanced Trauma Life Support algorithm, and CTC should receive emphasis as the diagnostic gold standard.